Development and Formative Evaluation of a Narrative-Based Serious Game for Pregnancy Education: Mixed Methods Study.

Area of Science:

• Digital Health
• Serious Games in Education
• Maternal Health Promotion

Background:

• Serious games are increasingly used for health education, particularly in maternal health.
• Existing digital interventions often focus on specific behaviors, lacking comprehensive, longitudinal pregnancy simulations.
• There's a need for interventions that incorporate psychosocial and administrative aspects of the pregnancy journey.

Purpose of the Study:

• To develop and evaluate a narrative-based serious game simulating the chronological course of pregnancy.
• To assess the game's perceived educational usefulness, accessibility, and user acceptance across multiple platforms.

Main Methods:

• A 9-chapter interactive serious game was developed using a visual novel engine by a pediatrician and medical students.
• The game covered key pregnancy stages and consultations, released on iOS, Android, and Steam.
• Postgame surveys and platform analytics were used for evaluation, with Ethics Committee approval.

Main Results:

• 65 users completed the survey; most were young females (10-19 years).
• Gameplay scores were balanced; educational outcomes like reduced anxiety and knowledge acquisition were rated highly (mean >3.8).
• The game achieved 925 downloads with positive reception, especially on Steam, indicating broad international appeal.

Conclusions:

• A low-cost, clinician-student collaborative model yielded a serious pregnancy education game with high perceived usefulness and user acceptance.
• Narrative-based serious games offer an accessible and scalable approach to maternal health education.
• Further research with rigorous designs is needed to confirm long-term educational and behavioral impacts.